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Grande E, Alicandro G, Vichi M, Pompili M, Frova L. Suicide After Partner's Death in the Elderly Population: Results From a Nationwide Cohort Study in Italy. Am J Geriatr Psychiatry 2024; 32:825-831. [PMID: 38342662 DOI: 10.1016/j.jagp.2024.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/13/2024]
Abstract
OBJECTIVE This study aims to investigate the effect of partner loss on suicide mortality for surviving partners in the elderly Italian population and to explore differences according to sex and time elapsed since the loss. DESIGN This was a historical cohort study. SETTING All Italian residents registered by the 15th Italian Population Census (9 October 2011) were linked to emigration records and death certificates for 2012-2017 to track migration, vital status, and cause of death. PARTICIPANTS 5,068,414 individuals living as a couple, as registered in the census, and aged ≥69 years on January 1, 2012. MEASUREMENTS Mortality rate ratios (MRR) estimated through Poisson regression models were used to compare suicide mortality at age ≥75 years between subjects who experienced partner loss and those who did not. RESULTS Among people who experienced partner loss, there were 383 suicide deaths in men and 90 in women. Suicide mortality was higher in older men and women who experienced the loss compared to those who did not, and the impact of the spouse loss on mortality was stronger in men (age-adjusted MRR=2.83) than in women (1.41). Among men the excess risk was particularly high during the first year following the loss; in women, no substantial differences in the excess risk were observed over the follow-up period. CONCLUSION Study findings provide evidence of the sex differences in the impact of spouse loss based on data from a large national cohort and reinforce the need for monitoring suicide risk in recently widowed older people.
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Affiliation(s)
- Enrico Grande
- Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics (EG, LF), Rome, Italy.
| | - Gianfranco Alicandro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano (GA), Milano, Italy; Department of Paediatrics, Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (GA), Milano, Italy
| | - Monica Vichi
- Statistical Service, Istituto Superiore di Sanità (MV), Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome (MP), Italy
| | - Luisa Frova
- Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics (EG, LF), Rome, Italy
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Ki M, Lapierre S, Gim B, Hwang M, Kang M, Dargis L, Jung M, Koh EJ, Mishara B. A systematic review of psychosocial protective factors against suicide and suicidality among older adults. Int Psychogeriatr 2024; 36:346-370. [PMID: 38305360 DOI: 10.1017/s104161022300443x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND Research on suicide rarely focuses on protective factors. The goal of this systematic review was to assess the evidence of the associations between protective factors and reduced suicidality among older adults. METHOD First, a scoping review was conducted to identify pertinent terms that refer to various protective factors against suicidality. A systematic review, following the PRISMA guidelines, was then conducted on a selection of 15 protective factors (e.g., perceived control, well-being and quality of life, life satisfaction, purpose-in-life, resilience, coping, religiosity, hope, self-regulation, sense of belonging, mattering, positive relationship, social support, social connectedness, and social participation), with separate searches performed on each factor in five databases. Empirical studies were eligible if participants were adults aged 60 years and over, and if the studies reported predictive statistical analysis. RESULTS A total of 70 studies were retained for the review. Suicidal ideation was the main outcome measure (91%). Significant associations were consistently observed between all protective factors and reduced suicidal ideations or behaviors, particularly for purpose-in-life, resilience, and positive relationships, indicating that these are solid components for suicide prevention. Using scales, instead of a single item, to measure protective factors (e.g. life satisfaction) was more efficient to capture the associations. On the other hand, results were similar whether studies used subjective (e.g., sense of belonging) or objective (e.g., social connectedness) measures. CONCLUSION Protective factors were inversely associated with suicidal ideation. Improving protective factors is essential for the development of late-life suicide prevention and interventions, instead of merely focusing on risk factors.
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Affiliation(s)
- Myung Ki
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
- Brain Korea 21 Four Research and Education Center, Korea University, Seoul, South Korea
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Sylvie Lapierre
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montréal, Canada
| | - Boeun Gim
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Minji Hwang
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
- Brain Korea 21 Four Research and Education Center, Korea University, Seoul, South Korea
| | - Minku Kang
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Luc Dargis
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montréal, Canada
| | - Myoungjee Jung
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Emily Jiali Koh
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
| | - Brian Mishara
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montréal, Canada
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Sahraian A, Sepehrtaj SN, Sepehrtaj SS, Kamyab P. Characteristics and related factors of suicide attempts among patients admitted to an Iranian poisoning center: Implications for suicide prevention. Heliyon 2023; 9:e20083. [PMID: 37809387 PMCID: PMC10559819 DOI: 10.1016/j.heliyon.2023.e20083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Background Suicide is a major public health concern worldwide. Iran is no exception, with suicide rates increasing in recent years. Understanding the characteristics and related factors of suicide attempts can help inform suicide prevention efforts in Iran. Methods A cross-sectional study was conducted on patients who attempted suicide and were admitted to the poisoning emergency of an intoxication center in Shiraz, Iran, between November 2019 and January 2020. Data were collected using data sheets containing study variables completed by oral interviewers and analyzed using descriptive and inferential statistics. Results The study included 302 individuals, with the majority being females (63.6%), and the mean age was 28.19 (SD 19.25) years. The majority of patients were living in urban areas (82.5%) and unmarried (60.9%). Medical drug abuse was the most common method of self-poisoning (76.5%), followed by narcotics (15.6%). Suicide attempts were predominantly carried out at night (59.9%) and on working days (78.5%). Most patients had no history of previous suicidal attempts (64.2%), psychiatric problems (64.6%), or physical illnesses (84.8%). Female gender (P = 0.017) and the presence of an underlying disease (P = 0.016) were the two risk factors significantly associated with suicide on non-working days. Conclusion Our study highlights the need for comprehensive suicide prevention strategies that consider the complex interplay of individual, sociocultural, and environmental factors that contribute to suicidal behaviors. The high proportion of female suicide attempters and the timing of suicide attempts suggest the need for gender-specific suicide prevention programs and focused suicide prevention efforts during high-risk periods. Additionally, the association between physical illnesses and suicide attempts underscores the importance of integrated mental and physical health care services.
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Affiliation(s)
- Ali Sahraian
- Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Parnia Kamyab
- Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Jeong KH, Yoon JY, Lee S, Cho S, Woo HJ, Kim S. Changes in the Suicide Rate of Older Adults According to Gender, Age, and Region in South Korea from 2010 to 2017. Healthcare (Basel) 2022; 10:2333. [PMID: 36421657 PMCID: PMC9690192 DOI: 10.3390/healthcare10112333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 08/20/2024] Open
Abstract
BACKGROUND South Korea's suicide rates are the highest among Organization for Economic Co-operation and Development (OECD) countries, making it one of the most important societal issues in South Korea. METHODS the statistics on causes of death and resident registration central population (RRCP) provided by the National Statistical Office were used to calculate the suicide rate among older adults in Korea. We examined gender (male, female), age (young-old, old-old), and region (urban, rural) by conducting latent growth modeling to estimate changes in the overall older adult suicide rate and verify its relationship. RESULTS over a period of 8 years, the older adult suicide rate was 104.232 on average in 2010 and it decreased by approximately 10.317 every year, and the rate of decrease gradually slowed down. The initial value of the older adult suicide rate was found to be higher among males, the old-old group, and those living in rural regions. In the quadratic function change rate, only males and the old-old group were statistically significant. CONCLUSION in this study, the direction of and the rate of change in the older adult suicide rates and the relationship between gender, age, and region were examined. It is expected that this study will provide basic data to assist in establishing older adult suicide prevention policies, considering the gender, age, and region of the aging population.
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Affiliation(s)
- Kyu-Hyoung Jeong
- Department of Social Welfare, Semyung University, Jecheon 27136, Republic of Korea
| | - Ji-Yeon Yoon
- Institute for Life and Culture, Sogang University, Seoul 04100, Republic of Korea
| | - Seoyoon Lee
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul 03722, Republic of Korea
| | - Sunghwan Cho
- School of Social Work, Virginia Commonwealth University, Richmond, VA 23223, USA
| | - Hyun-Jae Woo
- Health & Welfare Committee, Seoul Metropolitan Council, Seoul 04519, Republic of Korea
| | - Sunghee Kim
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul 03722, Republic of Korea
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Wang J, Ma Z, Jia C, Wang G, Zhou L. Suicide among young-old and old-old adults in rural China: A case-control psychological autopsy study. Int J Geriatr Psychiatry 2022; 37. [PMID: 36226326 DOI: 10.1002/gps.5819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/29/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Late-life suicide is a vital public health concern. Though gerontological research suggested the young-old and old-old phases were heterogeneous, age differences in the elderly suicide have not been well studied due to the lack of comparable control groups and small samples. The study aimed to examine the age-specific suicidal characteristics and risk factors among the young-old (60-79) and old-old (over 80) elderly. METHODS Two hundred and forty two suicide decedents and 242 living comparisons were enrolled in a 1:1 matched case-control psychological autopsy study in rural China: 173 young-old and 69 old-old in each group. Suicidal characteristics, demographic characteristics, living arrangements, physical health, mental disorder, and psychosocial factors were collected. We used logistic regression models to assess risk factors of suicide and test for interactions between age and each risk factor. RESULTS Pesticide suicide was more prevalent among young-old suicides than old-old suicides (56.07% vs. 40.58%, p = 0.029). Non-currently married, unemployment, mental disorder, higher disability in physical activities of daily living, higher hopelessness and higher depressive symptom were significantly associated with suicide among older adults. The effect of poor function in physical activities of daily living on suicide was significantly greater during younger ages (p for interaction = 0.038). CONCLUSIONS Findings indicated that most suicidal characteristics and risk factors for completed suicide were generally similar among young-old and old-old adults. But poor function in physical activities of daily living predicted increase suicide risk only at younger ages. In addition to common risk factors, age-specific factors should also be noted in suicide prevention. CLINICAL TRIAL REGISTRATION According to the ICMJE, purely observational studies (those in which the assignment of the medical intervention is not at the discretion of the investigator) will not require registration. Our study was not registered because this is a case-control study. But all procedures of the study were carried out in accordance with the latest version of the Declaration of Helsinki. The study were approved by the Institutional Review Boards of the Central South University, Shandong University, and Guangxi Medical University.
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Affiliation(s)
- Jiali Wang
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhenyu Ma
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Cunxian Jia
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | | | - Liang Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
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Chattun MR, Amdanee N, Zhang X, Yao Z. Suicidality in the geriatric population. Asian J Psychiatr 2022; 75:103213. [PMID: 35917739 DOI: 10.1016/j.ajp.2022.103213] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/01/2022] [Accepted: 07/14/2022] [Indexed: 11/28/2022]
Abstract
Suicide in older adults is a major global concern in both public and mental health. With an ageing population on the rise, a surge in suicidal deaths is predicted in the coming years. The objectives of this paper are to review the risk factors, protective factors, assessment rating scales and current prevention strategies in the geriatric population. The identification of modifiable risk factors and strengthening of protective factors as well as staging according to suicidal ideation, behaviors and/or attempt(s) are necessary to devise appropriate personalized interventions in vulnerable older adults. A history or current psychiatric illness particularly depression, physical illnesses, previous suicide attempt, substance abuse, loneliness, marital status, financial stress, a family history of psychiatric illnesses or suicide in 1st degree relatives and low social support most commonly increase suicidal susceptibility in older adults. Conversely, factors that increase resilience in older adults include a good physical health and cognitive function, religiousness, good quality of life and life satisfaction, ability to perform activities of daily living, marital status, having friends and social connectedness. While the risk factors associated with suicide in the geriatric population are complex and multidimensional in nature, the current preventive strategies have provided no substantial decline in suicidal risk. Therefore, a combination of strategies applied via a multilevel prevention program at a primary, mental healthcare, societal and community level could mitigate suicidal risk. Further research and better preventive measures are warranted to diminish suicidal risk in older adults.
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Affiliation(s)
- Mohammad Ridwan Chattun
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Nousayhah Amdanee
- Department of Geriatric Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xiangrong Zhang
- Department of Geriatric Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China.
| | - Zhijian Yao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; Medical School of Nanjing University, Nanjing Brain Hospital, 22 Hankou Road, Nanjing 210093, China.
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Grande E, Vichi M, Alicandro G, Marchetti S, Frova L, Pompili M. Suicide mortality among the elderly population in Italy: A nationwide cohort study on gender differences in sociodemographic risk factors, method of suicide, and associated comorbidity. Int J Geriatr Psychiatry 2022; 37. [PMID: 35524717 DOI: 10.1002/gps.5726] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 04/20/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES This study aimed at investigating gender differences in the relationship between sociodemographic factors and suicide mortality, as well as in the method used for suicide and the presence of comorbidities in an older population in Italy. METHODS/DESIGN We conducted a historical cohort study based on individual record linkage across the 15th Italian Population Census, the Italian Population Register, and the National Register of Causes of Death. Suicides among people aged 75 years or older from 2012 to 2017 were analyzed. Crude mortality rates were computed, and cause-specific mortality rate ratios were estimated using negative binomial regression models. Chi-square tests were used to evaluate significant gender differences in suicide methods and comorbidities associated with suicide. RESULTS The study included 9,686,698 individuals (41% men, 59% women). Compared to living alone, living with children or partners reduced suicide mortality, especially among men. Having high or medium educational levels was associated with lower mortality than low educational levels among men. Foreign citizens had lower mortality among men, but not among women. Living in urban areas was associated with lower suicide rates in men and higher rates in women. Methods of suicide significantly differed by gender: leading methods were hanging, strangulation, and suffocation in men, and falling from height in women. Mental comorbidity was significantly more frequent among women, especially at ages 75-84 years. CONCLUSIONS We believe that our findings might help to promote public health strategies taking gender differences in old age into account to improve social support and quality of life of older men and women.
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Affiliation(s)
- Enrico Grande
- National Institute of Statistics, Integrated System for Health, Social Assistance and Welfare, Rome, Italy
| | - Monica Vichi
- Statistical Service, Istituto Superiore di Sanità, Rome, Italy
| | - Gianfranco Alicandro
- National Institute of Statistics, Integrated System for Health, Social Assistance and Welfare, Rome, Italy.,Department of Pathophysiology and Transplantatation, Università degli Studi di Milano, Milan, Italy.,Cystic Fibrosis Center, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Marchetti
- National Institute of Statistics, Integrated System for Health, Social Assistance and Welfare, Rome, Italy
| | - Luisa Frova
- National Institute of Statistics, Integrated System for Health, Social Assistance and Welfare, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Fernandez-Rodrigues V, Sanchez-Carro Y, Lagunas LN, Rico-Uribe LA, Pemau A, Diaz-Carracedo P, Diaz-Marsa M, Hervas G, de la Torre-Luque A. Risk factors for suicidal behaviour in late-life depression: A systematic review. World J Psychiatry 2022; 12:187-203. [PMID: 35111588 PMCID: PMC8783161 DOI: 10.5498/wjp.v12.i1.187] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/17/2021] [Accepted: 11/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Suicide is a leading cause of preventable death worldwide, with its peak of maximum incidence in later life. Depression often puts an individual at higher risk for suicidal behaviour. In turn, depression deserves particular interest in old age due to its high prevalence and dramatic impact on health and wellbeing. AIM To gather integrated evidence on the potential risk factors for suicide behaviour development in depressive older adults, and to examine the effects of depression treatment to tackle suicide behaviour in this population. METHODS A systematic review of empirical studies, published from 2000 onwards, was conducted. Suicidal behaviour was addressed considering its varying forms (i.e., wish to die, ideation, attempt, and completed suicide). RESULTS Thirty-five papers were selected for review, comprising both clinical and epidemiological studies. Most of studies focused on suicidal ideation (60%). The studies consistently pointed out that the risk was related to depressive episode severity, psychiatric comorbidity (anxiety or substance use disorders), poorer health status, and loss of functionality. Reduced social support and loneliness were also associated with suicide behaviour in depressive older adults. Finally, the intervention studies showed that suicidal behaviour was a robust predictor of depression treatment response. Reductions in suicidal ideation were moderated by reductions in risk factors for suicide symptoms. CONCLUSION To sum up, common and age-specific risk factors seem to be involved in suicide development in depressive older adults. A major effort should be made to tackle this serious public health concern so as to promote older people to age healthily and well.
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Affiliation(s)
| | - Yolanda Sanchez-Carro
- Department of Psychiatry, Universidad Autonoma de Madrid, Madrid 28046, Spain
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid 28029, Spain
| | - Luisa Natalia Lagunas
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid 28046, Spain
| | - Laura Alejandra Rico-Uribe
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid 28029, Spain
- Department of Psychology, La Rioja International University, Logrono 26006, Spain
| | - Andres Pemau
- Department of Psychology, Universidad Complutense de Madrid, Madrid 28223, Spain
| | | | - Marina Diaz-Marsa
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid 28029, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid 28046, Spain
- Institute of Psychiatry and Mental Health, San Carlos Clinical Hospital, Madrid 28040, Spain
| | - Gonzalo Hervas
- Department of Psychology, Universidad Complutense de Madrid, Madrid 28223, Spain
| | - Alejandro de la Torre-Luque
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid 28029, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid 28046, Spain
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De Leo D, Giannotti AV. Suicide in late life: A viewpoint. Prev Med 2021; 152:106735. [PMID: 34538377 PMCID: PMC8443431 DOI: 10.1016/j.ypmed.2021.106735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/06/2021] [Accepted: 07/16/2021] [Indexed: 01/07/2023]
Abstract
Suicide in old age represents a sad public health concern. Despite the global decline in rates of suicide and the general amelioration of quality of life and access to health care for older adults, their rates of suicide remain the highest virtually in every part of the world. With the aging of the world population and the growing number of mononuclear families, the risk of an increase in isolation, loneliness and dependency does not appear ungrounded. The Covid-19 pandemic is claiming the life of many older persons and creating unprecedented conditions of distress, particularly for this segment of the population. This article briefly examines the main characteristics of suicidal behavior in late life, including observations deriving from the spread of the Sars-2 coronavirus and possible strategies for prevention.
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Hernandez SC, Overholser JC, Philips KL, Lavacot J, Stockmeier CA. Suicide among older adults: Interactions among key risk factors. Int J Psychiatry Med 2021; 56:408-421. [PMID: 33322985 DOI: 10.1177/0091217420982387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The present study aimed to understand how key risk factors of older adult suicide interact to ultimately lead to death by suicide using data collected post-mortem. METHOD A psychological autopsy was used to gather detailed information about psychiatric diagnosis, medical problems, social isolation, and negative attitudes expressed by the individual during the six months prior to their death. Interviews with next-of-kin, medical and psychiatric records, and the Cumulative Illness Rating Scale for Geriatrics were used. Subjects included 32 older adults who died by suicide and 45 older adults who died by natural causes. RESULTS Hopelessness, depression, and negative health attitudes were strongly correlated with suicide. Older age was associated with social isolation, suggesting an indirect relationship with suicide via hopelessness, depression, and negative health attitudes. Physical illness did not increase risk. Multivariate analyses suggested that hopelessness fully mediated the effects of social isolation, negative health attitudes, and depression on suicide. CONCLUSIONS Psychological factors played the largest role in suicide deaths compared to social isolation and physical illness. Suicide interventions aimed at older adults should ensure hopelessness, depression, and negative health attitudes are primary targets.
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Affiliation(s)
- Silvia C Hernandez
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - James C Overholser
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Kristie L Philips
- Veterans Affairs Northeast Ohio Healthcare System, Cleveland, OH, USA
| | - James Lavacot
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Craig A Stockmeier
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MI, USA
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Shoib S, Islam SMS, Arafat SY, Hakak SA. Depression and suicidal ideation among the geriatric population of Kashmir, India. Int J Soc Psychiatry 2021; 67:651-655. [PMID: 33100095 DOI: 10.1177/0020764020968592] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Depression is a common disorder that can lead to suicidal behaviours among the geriatric population. AIM We aimed to assess depression, hopelessness, and suicidal ideation among the elderly population of Kashmir. METHODS A community-based cross-sectional study was conducted in three districts of Kashmir between June and August 2019. The sample consisted of 200 persons aged >65 years. Beck's Depression Inventory, Beck's Hopelessness Scale, and the Beck Suicide Ideation scale were used to determine depression, hopelessness, and suicide ideation. Pearson's correlation was performed to assess the relationships between depression, hopelessness, and suicide. RESULTS The prevalence of severe depression with a score of ⩾31 on Beck's Depression Inventory was 56% among the studied population. Most of these elderly were found to have moderate levels of suicidal ideation (62.5%) and hopelessness (61%). Depression had a positive correlation with suicidal ideation (r = 0.35). Hopelessness and suicidal intent had a more significant positive correlation (r = 0.54), as compared to depression and hopelessness (r = 0.43). CONCLUSION More than half of the older persons in Kashmir had depression with superimposed hopelessness which is an important risk factor of suicidal ideation.
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Affiliation(s)
- Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital (JLNMH), Rainawari, Srinagar, Jammu and Kashmir, India
| | | | - Sm Yasir Arafat
- Department of Psychiatry, Enam Medical College and Hospital, Dhaka, Bangladesh
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Makara-Studzińska M, Somasundaram SG, Halicka J, Madej A, Leszek J, Rehan M, Ashraf GM, Gavryushova LV, Nikolenko VN, Mikhaleva LM, Muresanu C, Kirkland CE, Avila-Rodriguez M, Aliev G. Suicide and Suicide Attempts in Elderly Patients: An Epidemiological Analysis of Risk Factors and Prevention. Curr Pharm Des 2021; 27:2231-2236. [PMID: 33243131 DOI: 10.2174/1381612826999201126202008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/16/2020] [Indexed: 11/22/2022]
Abstract
A number of elderly patients commit suicide due to the interaction of various factors, including, for example, feelings of loneliness, financial distress, alcohol abuse, chronic pain, progressive diseases, and personality disorders. The data from the EU countries with the highest rates of suicide and suicide attempts among people over 55 years of age warrant the consideration of new approaches to address this social problem. METHODS PubMed and other databases, including Polish National data, were used for the analyses. RESULTS The average European suicide-attempt rate is 18 per 100 thousand inhabitants. More cases of suicides were reported among those over 55 years of age. Suicide attempts from the year 2012 to 2014 and deaths in 2012 have been reviewed. The risk factors involved in these events, such as depression and social situations including loneliness, health condition, etc., have been discussed to suggest a plausible preventative approach for this important elderly problem. CONCLUSION The psychophysiology of elderly persons affected by retirement, socio-economic changes, limited personal autonomy, loneliness, lack of support by the family, and diseases ultimately may lead elderly patients to commit suicide. Thus, financial freedom, family support (respect, love, and care), proper medications, psychological and psychiatric interventions may help the elderly avoid suicidal thoughts and prevent attempts.
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Affiliation(s)
| | - Siva G Somasundaram
- Department of Biological Sciences, Salem University, Salem WV 26426, United States
| | - Joanna Halicka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Agata Madej
- Department of Applied Psychology, Medical University of Lublin, Lublin, Poland
| | - Jerzy Leszek
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Mohd Rehan
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ghulam M Ashraf
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Liliya V Gavryushova
- Saratov State Medical University named after V.I. Razumovsky, 410012, Saratov, Russian Federation
| | - Vladimir N Nikolenko
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Str., Moscow, 119991, Russian Federation
| | - Liudmila M Mikhaleva
- Federal State Budgetary Institution «Research Institute of Human Morphology», 3, Tsyurupy Str., Moscow, 117418, Russian Federation
| | - Cristian Muresanu
- Romanian Television, TVR Cluj, 160 Donath Street, Cluj-Napoca, CJ 400293, Romania
| | - Cecil E Kirkland
- Department of Biological Sciences, Salem University, Salem WV 26426, United States
| | - Marco Avila-Rodriguez
- Health Sciences Faculty, Clinic Sciences Department, University of Tolima, 730006 Ibague, Colombia
| | - Gjumrakch Aliev
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka, 142432, Russian Federation
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13
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Beghi M, Butera E, Cerri CG, Cornaggia CM, Febbo F, Mollica A, Berardino G, Piscitelli D, Resta E, Logroscino G, Daniele A, Altamura M, Bellomo A, Panza F, Lozupone M. Suicidal behaviour in older age: A systematic review of risk factors associated to suicide attempts and completed suicides. Neurosci Biobehav Rev 2021; 127:193-211. [PMID: 33878336 DOI: 10.1016/j.neubiorev.2021.04.011] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 11/28/2022]
Abstract
In older age, several observational studies investigated risk factors for suicide attempts/completed suicides; however, contrasting evidence came from population-based setting. In the present systematic review, we described through a narrative synthesis the significant associations existing among risk factors and suicide attempts/completed suicides in subjects aged >65 years. From the 39 population-based studies selected in six different databases until February 15, 2021, we analyzed the most frequent 28 risk factors for suicidal behaviour. The risk factors more associated to suicide attempts than other variables frequently related to suicidal behavior in older age were: depressive disorders, methods employed to self-harm (particularly poisoning), and psychotropic drug utilization followed by psychological factors and disability. Moreover, male sex, violent methods to self-harm, any psychiatric disorder (depression, anxiety and bipolar disorders), a poor medical condition, stressors/bereavement, and living alone appeared to be more significant for predicting completed suicides in late life. In older age, efforts for suicide prevention should be based on strategies to assess and treat psychiatric disorders along with psychological interventions, particularly in males.
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Affiliation(s)
| | - Elisa Butera
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | | | | | - Francesca Febbo
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Anita Mollica
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Berardino
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy; School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Emanuela Resta
- Translational Medicine and Management of Health Systems, University of Foggia, Foggia, Italy
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Clinical Research in Neurology, Pia Fondazione Cardinale G. Panico, Tricase, Lecce, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy; Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Mario Altamura
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesco Panza
- Healthy Aging Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio de Bellis" Research Hospital, Castellana Grotte, Bari, Italy.
| | - Madia Lozupone
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
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14
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Stoychev K, Dimitrova E, Nakov V, Stoimenova-Popova M, Chumpalova P, Veleva I, Mineva-Dimitrova E, Dekov D. Socio-Demographic and Clinical Characteristics of Psychiatric Patients Who Have Committed Suicide: Analysis of Bulgarian Regional Suicidal Registry for 10 Years. Front Psychiatry 2021; 12:665154. [PMID: 34489748 PMCID: PMC8417357 DOI: 10.3389/fpsyt.2021.665154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 07/27/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Suicide is a major public health problem but factors determining suicide risk are still unclear. Studies in this field in Bulgaria are limited, especially on a regional level. Methods: By a cross-sectional design, we accessed the medical records of all psychiatric patients committed suicide over a 10-year period (2009-2018) in one major administrative region of Bulgaria. A statistical analysis was performed of the association between age of suicide as an indirect yet measurable expression of the underlying suicidal diathesis and a number of socio-demographic and clinical characteristics. Results: Seventy-seven of 281 suicides (28%) had psychiatric records. Most common diagnoses were mood disorders (44%), followed by schizophrenia (27%), anxiety disorders (10%), substance use disorders (9%) and organic conditions (8%). Male gender, single/divorced marital status, early illness onset, co-occurring substance misuse and lower educational attainment (for patients aged below 70) were significantly associated with earlier age of suicide whereas past suicide attempts and psychiatric hospitalizations, comorbid somatic conditions and unemployment showed insignificant association. Substantial proportion of patients (60%) had contacted psychiatric service in the year preceding suicide, with nearly half of these encounters being within 30 days of the accident. Conclusion: Severe mental disorders are major suicide risk factor with additional contribution of certain socio-demographic and illness-related characteristics. Monitoring for suicidality must be constant in chronic psychiatric patients. Registration of suicide cases in Bulgaria needs improvement in terms of information concerning mental health. More studies with larger samples and longitudinal design are needed to further elucidate distal and proximal suicide risk factors.
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Affiliation(s)
- Kalyan Stoychev
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | - Emilia Dimitrova
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | - Vladimir Nakov
- Department of Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Maya Stoimenova-Popova
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | - Petranka Chumpalova
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | - Ivanka Veleva
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | | | - Dancho Dekov
- Deparment of General Medicine, Forensic Medicine, and Deontology, Medical University Pleven, Pleven, Bulgaria
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15
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Analysis of attempted suicide episodes presenting to the emergency department: comparison of young, middle aged and older people. Int J Ment Health Syst 2020; 14:46. [PMID: 32582367 PMCID: PMC7310195 DOI: 10.1186/s13033-020-00378-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 06/15/2020] [Indexed: 11/24/2022] Open
Abstract
Background Attempted suicide remains difficult for clinicians to predict with some established risk factors. We investigate the detailed characteristics of attempted suicide especially according to age and methods of suicide attempts. Methods A retrospective study was conducted to evaluate patients who visited the emergency department due to attempted suicide. A retrospective medical record review of all patients who presented to the emergency department (ED) of two tertiary teaching hospitals in Korea after suicide attempt between January 1, 2010, and December 31, 2017 was performed. Demographic information and detailed variables (methods and reasons of suicide attempts and variables regarding reattempts) were investigated. Total participants were classified into 3 groups according to age, young group, middle aged group and the older group, and each characteristics were compared. Results A total of 3698 patients were enrolled in this study. Deliberate self-poisoning (DSP) was the most common method of attempted suicide (66.5%) followed by cutting (24.4%), hanging (7.9%), falling (2.6%), and drowning (1.1%). In patients who had previous suicide attempts (n = 1029, 27.8%), attempted methods were likely to be concordant with previous attempted methods. The most common reason for suicide attempts was interpersonal relationship issues followed by socio-economic reasons. Older patients (n = 412, 11.2%) were significantly different from other 2 groups (n = 3286, 88.8%) regarding gender, suicide re-attempt, occupation, alcohol co-ingestion, previous psychiatric history, and discharge outcomes (all p-values < 0.001). Especially, in older patients, use of critical method and reason of physical illness were more common. Conclusion Our findings indicated that people who attempted suicide might have different sociodemographic and clinical factors depending on age group. Depending on age, it is necessary to apply additional suicide intervention programs in different ways.
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16
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Yeh ST, Ng YY, Wu SC. Association of psychiatric and physical illnesses with suicide in older adults in Taiwan. J Affect Disord 2020; 264:425-429. [PMID: 31767216 DOI: 10.1016/j.jad.2019.11.070] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 09/17/2019] [Accepted: 11/12/2019] [Indexed: 01/24/2023]
Abstract
OBJECTIVE This study aimed to investigate the association of psychiatric and physical illnesses with suicide in older adults in Taiwan. METHODS A nationwide database in Taiwan was used for this matched case-control study. Elderly participants with and without intentional self-harm from 2010 to 2012 were matched by propensity score by calendar year, gender, age, and area of residence. Psychiatric and physical illnesses were identified by tracing back 1 year from the date of death in suicide and from July 1 of the previous year to June 30 of the observational year in the controls. Associations between illnesses and the risk of suicide was assessed by conditional logistic regression analysis. RESULTS 2,528 older adults who died by suicide were studied, and the crude suicide mortality rate was 33.7 per 100,000. The risk of suicide in older adults with depression (AOR = 9.06, 95% CI = 6.07-13.52), cancer (AOR = 8.51, 95% CI = 5.39-13.45) and schizophrenia (AOR = 7.34, 95% CI = 2.65-20.33), were significantly higher than control group. Other illnesses, such as bipolar disorder, chronic obstructive pulmonary disease, stroke, chronic kidney disease, hypertension, and diabetes mellitus (AOR = 3.63, 2.41, 1.94, 1.73, 1.68, 1.45, respectively), showed lower risk but still significantly higher in older adults with suicide. CONCLUSIONS Psychiatric and physical illnesses, especially depression, cancer, and schizophrenia, were found to be independently associated with suicide in older adults. The result of this study can help clinicians to identify older adults at risk of suicide and open avenues for prevention.
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Affiliation(s)
- Shin-Ting Yeh
- College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
| | - Yee-Yung Ng
- Department of Medicine, School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
| | - Shiao-Chi Wu
- Institute of Health & Welfare Policy, National Yang-Ming University, 155, Sec. 2, Li-Nong Street, Taipei, Taiwan 112, Republic of China.
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17
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Costanza A, Amerio A, Radomska M, Ambrosetti J, Di Marco S, Prelati M, Aguglia A, Serafini G, Amore M, Bondolfi G, Michaud L, Pompili M. Suicidality Assessment of the Elderly With Physical Illness in the Emergency Department. Front Psychiatry 2020; 11:558974. [PMID: 33024437 PMCID: PMC7516267 DOI: 10.3389/fpsyt.2020.558974] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/21/2020] [Indexed: 12/13/2022] Open
Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland.,Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Andrea Amerio
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Mood Disorders Program, Tufts Medical Center, Boston, MA, United States
| | - Michalina Radomska
- Faculty of Psychology, University of Geneva (UNIGE), Geneva, Switzerland
| | - Julia Ambrosetti
- Emergency Psychiatric Unit, Department of Psychiatry and Emergency Department, Geneva University Hospitals, Geneva, Switzerland
| | - Sarah Di Marco
- Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Massimo Prelati
- Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Andrea Aguglia
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianluca Serafini
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Guido Bondolfi
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland.,Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Laurent Michaud
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.,McGill Group for Suicide Studies, McGill University, Montreal, QC, Canada
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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18
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Park CHK, Lee JW, Lee SY, Shim SH, Kim SG, Lee J, Kim MH, Paik JW, Cho SJ, Moon JJ, Jeon DW, Kim S, Park JH, You S, Jeon HJ, Ahn YM. Characteristics of the "young-old" and "old-old" community-dwelling suicidal Ideators: A longitudinal 6-month follow-up study. Compr Psychiatry 2019; 89:67-77. [PMID: 30597426 DOI: 10.1016/j.comppsych.2018.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 11/20/2018] [Accepted: 12/04/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Despite heterogeneity of older people in suicidal behavior, research identifying characteristics by age groups is scarce. We examined baseline features of older community-dwelling suicidal ideators by dichotomized age groups and the 6-month trajectory of their suicidal ideation along with its related psychopathology. Predictors of suicidal ideation within each group were investigated. METHODS Older community-dwelling suicidal ideators enrolled in the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior study were subdivided into the "young-old (65-74 years)" and "old-old (≥75 years)" group. Baseline, 1-, and 6-month assessments were compared. Within each group, multiple regression analysis using rating scales (Patient Health Questionnaire-9, Beck Anxiety Inventory, Alcohol Use Disorders Identification Test, Stress Questionnaire for Korean National Health and Nutrition Examination Survey-Short Form, and Social Relationships Scale) was conducted to identify predictors of suicidal ideation measured with the intensity subscale of the Columbia-Suicide Severity Rating Scale. Two-way repeated-measures analysis of variance (RM-ANOVA) was used to compare changes in suicidal ideation, depression, anxiety between age groups over time, and one-way RM-ANOVA to examine changes within each age group. RESULTS Among 29 "young-old" and 53 "old-old" ideators, the latter were less likely to be receiving psychiatric treatment (odds ratio [OR] = 4.065) and make suicide attempts (OR = 2.874), whereas the former revealed greater levels of anxiety and stress. Baseline depression and stress in the "young-old" group and the "old-old" group, respectively, predicted the intensity of suicidal ideation at both baseline and 1-month assessments. No significant age group x time interactions on suicidal ideation and depression were found. However, within each age group, both suicidal ideation and depression significantly decreased only during the first month with no further improvement. CONCLUSION We speculate cautiously that more attention may need to be paid to the "old-old" ideators in the evaluation of psychiatric issues and for referral to psychiatrists. To decrease suicidal ideation, tailored approaches involving proactive, timely management of depression in the "young-old" and interventions focusing on stress reduction in the "old-old," would be helpful.
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Affiliation(s)
- C Hyung Keun Park
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Jae Won Lee
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Sang Yeol Lee
- Department of Psychiatry, Wonkwang University Hospital, 895 Muwang-ro, Iksan, Jeollabuk-do 54538, Republic of Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soon Chun Hyang University Cheonan Hospital, Soon Chun Hyang University, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, Republic of Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soon Chun Hyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi-do 14854, Republic of Korea.
| | - Jeewon Lee
- Department of Neuropsychiatry, Soon Chun Hyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi-do 14854, Republic of Korea
| | - Min-Hyuk Kim
- Department of Psychiatry, Wonju Severance Christian Hospital, 20 Ilsan-ro, Wonju, Gangwon-do 26426, Republic of Korea.
| | - Jong-Woo Paik
- Department of Psychiatry, Kyung Hee University Medical Center, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, 21 Namdongdae-ro 774 gil, Namdong-gu, Incheon 21565, Republic of Korea.
| | - Jung-Joon Moon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
| | - Dong-Wook Jeon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
| | - Seokho Kim
- Department of Sociology, College of Social Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Jae-Hyun Park
- Department of Social and Preventive Medicine, Sungkyunkwan University College of Medicine, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do 16419, Republic of Korea
| | - Sungeun You
- Department of Psychology, College of Social Sciences, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Chungcheongbuk-do 28644, Republic of Korea.
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea.
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
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19
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Zhou L, Wang G, Jia C, Ma Z. Being left-behind, mental disorder, and elderly suicide in rural China: a case-control psychological autopsy study. Psychol Med 2019; 49:458-464. [PMID: 29692283 PMCID: PMC6331683 DOI: 10.1017/s003329171800106x] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/22/2018] [Accepted: 03/22/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Suicide rate among rural elderly is the highest among all age groups in China, yet little is known about the suicide risks in this rapidly growing vulnerable population. METHODS This matched case-control psychological autopsy study was conducted during June 2014 to September 2015. Consecutive samples of suicides aged 60 or above were identified in three provinces (Shandong, Hunan, and Guangxi) in China. Living comparisons were 1:1 matched with the suicides in age (±3 years old), gender, and living location. Risk factors included demographic characteristics, being left-behind, mental disorder, depressive symptoms, stressful life events, and social support. RESULTS A total of 242 suicides and 242 comparisons were enrolled: 135 (55.8%) were male, mean (s.d.) age was 74 (8) years. The most frequently used suicide means were pesticides (125, 51.7%) and hanging (95, 39.3%). Independent risks of suicide included unstable marital status [odds ratio (OR) 4.19, 95% confidence interval (CI) 1.61-10.92], unemployed (compared with employed, OR 4.43, 95% CI 1.09-17.95), depressive symptoms (OR 1.34, 95% CI 1.21-1.48), and mental disorder (OR 6.28, 95% CI 1.75-22.54). Structural equation model indicated that the association between being left-behind and suicide was mediated by mental disorder, depressive symptoms, stressful life events, and social support. CONCLUSIONS Unstable marital status, unemployed, depressive symptoms, and mental disorder are independent risk factors for suicide in rural elderly. Being left-behind can elevate the suicide risk through increasing life stresses, depressive symptoms, mental disorder, and decreasing social support. Elderly suicide may be prevented by restricting pesticides, training rural physicians, treating mental disorders, mitigating life stress, and enhancing social connection.
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Affiliation(s)
- Liang Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Guojun Wang
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Cunxian Jia
- School of Public Health, Shandong University, Jinan, China
| | - Zhenyu Ma
- School of Public Health, Guangxi Medical University, Nanning, China
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20
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Kim H, Ahn JS, Kim H, Cha YS, Lee J, Kim MH, Min S. Sociodemographic and clinical characteristics of old-old suicide attempters compared with young-old and middle-aged attempters. Int J Geriatr Psychiatry 2018; 33:1717-1726. [PMID: 30264415 DOI: 10.1002/gps.4976] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 08/06/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The purpose of this study was to identify distinctive characteristics of old-old suicide attempters (75 years and older) from young-old (60-74 years old) and middle-aged suicide attempters (45-59 years old). METHODS We included consecutive series of 920 patients aged 45 years and older who had visited the emergency room from 2009 to 2015 because of suicide attempts. They were divided into 3 groups according to age. Information about the suicide attempt and sociodemographic status was gathered through interviews with attempters or caregivers. Chi-square test and logistic regression analysis were performed to evaluate the differences among the 3 groups. RESULTS We found that old-old suicide attempters had high intent to die and high medical lethality as a result of the attempt, and illness-related problems exerted a strong motivational effect on this group. Psychiatric drugs, pesticides, and herbicides were frequently used to attempt suicide. These attempts were less likely to be associated with alcohol consumption compared to other age groups. CONCLUSION Old-old suicide attempters have different characteristics, compared with young-old and middle-aged counterparts. It is necessary to assess suicide risk and depression when examining patients with physical illness or when prescribing psychotropic drugs. High-risk groups should be given immediate intervention including psychiatric treatment before they act on high suicide intent.
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Affiliation(s)
- HeungKyu Kim
- Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital, Seoul, Republic of Korea
| | - Joung-Sook Ahn
- Department of Psychiatry, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyun Kim
- Department of Emergency Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Yong Sung Cha
- Department of Emergency Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Jinhee Lee
- Department of Psychiatry, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Min-Hyuk Kim
- Department of Psychiatry, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea
| | - Seongho Min
- Department of Psychiatry, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea.,Wonju Mental Health Center, Wonju, Republic of Korea
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21
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Berardelli I, Corigliano V, Hawkins M, Comparelli A, Erbuto D, Pompili M. Lifestyle Interventions and Prevention of Suicide. Front Psychiatry 2018; 9:567. [PMID: 30459660 PMCID: PMC6232529 DOI: 10.3389/fpsyt.2018.00567] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/18/2018] [Indexed: 12/26/2022] Open
Abstract
Over the past years, there has been a growing interest in the association between lifestyle psychosocial interventions, severe mental illness, and suicide risk. Patients with severe mental disorders have higher mortality rates, poor health states, and higher suicide risk compared to the general population. Lifestyle behaviors are amenable to change through the adoption of specific psychosocial interventions, and several approaches have been promoted. The current article provides a comprehensive review of the literature on lifestyle interventions, mental health, and suicide risk in the general population and in patients with psychiatric disorders. For this purpose, we investigated lifestyle behaviors and lifestyle interventions in three different age groups: adolescents, young adults, and the elderly. Several lifestyle behaviors including cigarette smoking, alcohol use, and sedentary lifestyle are associated with suicide risk in all age groups. In adolescents, growing attention has emerged on the association between suicide risk and internet addiction, cyberbullying and scholastic and family difficulties. In adults, psychiatric symptoms, substance and alcohol abuse, weight, and occupational difficulties seems to have a significant role in suicide risk. Finally, in the elderly, the presence of an organic disease and poor social support are associated with an increased risk of suicide attempt. Several factors may explain the association between lifestyle behaviors and suicide. First, many studies have reported that some lifestyle behaviors and its consequences (sedentary lifestyle, cigarette smoking underweight, obesity) are associated with cardiometabolic risk factors and with poor mental health. Second, several lifestyle behaviors may encourage social isolation, limiting the development of social networks, and remove individuals from social interactions; increasing their risk of mental health problems and suicide.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Valentina Corigliano
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Michael Hawkins
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Anna Comparelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Denise Erbuto
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Berardelli I, Belvisi D, Corigliano V, Costanzo M, Innamorati M, Fabbrini G, Berardelli A, Pompili M. Suicidal ideation, perceived disability, hopelessness and affective temperaments in patients affected by Parkinson's disease. Int J Clin Pract 2018; 73:e13287. [PMID: 30339296 DOI: 10.1111/ijcp.13287] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 08/26/2018] [Accepted: 10/15/2018] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND Previous studies investigating the risk of suicide in patients with Parkinson's disease (PD) have reported conflicting results. This study evaluated suicide risk in PD and investigated the relationship between suicide risk and perceived disability, hopelessness and affective temperaments in PD. METHODS One-hundred and twenty PD patients were consecutively enrolled. The diagnosis of PD was based on clinical criteria. All patients underwent a psychiatric evaluation that included the administration of the Columbia-Suicide Severity Rating Scale, the Italian Perceived Disability Scale, the Beck Hopelessness Inventory and the TEMPS-A questionnaire. The results were compared with those of a control group of 91 patients affected by another chronic disease, ie, open angle glaucoma. RESULTS Parkinson's disease patients had higher suicidal ideation, higher perceived disability and lower hyperthymia than the control group. In PD, higher perceived disability was associated with higher current and lifetime suicidal ideation, lower hyperthymia, older age and higher scores on negative temperaments. Suicidal ideation, negative temperaments and hopelessness were risk factors for perceived disability, while hyperthymia was a protective factor for perceived disability. DISCUSSION Patients with PD have an increased risk of suicidal ideation. Increased suicidal ideation in PD is associated with the increased perceived disability. A psychiatric assessment that includes the investigation of suicide risk and perceived disability is recommended in patients with PD.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Valentina Corigliano
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Matteo Costanzo
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Rome, Italy
| | - Giovanni Fabbrini
- IRCSS Neuromed, Pozzilli, IS, Italy
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Alfredo Berardelli
- IRCSS Neuromed, Pozzilli, IS, Italy
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Efstathiou V, Papadopoulou A, Christodoulou C, Gournellis R, Michopoulos I, Ferentinos P, Papageorgiou C, Douzenis A. The Relationship between Hopelessness and Clinical Characteristics of Hospitalized Patients with Recent Suicide Attempt. Issues Ment Health Nurs 2018; 39:876-882. [PMID: 30252555 DOI: 10.1080/01612840.2018.1491656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study aimed to assess hopelessness in 170 hospitalized individuals with recent suicide attempt and examine its association with patients' characteristics, with a view to improving awareness in health professionals and especially nurses, who are among the first to take care of these patients. Participants completed Beck Hopelessness Scale and Beck Depression Inventory. More than half (51.18%) experienced moderate-to-severe hopelessness. A multiple linear regression analysis showed that age, attempted suicide method, past suicide attempt, and psychiatric diagnosis contributed statistically significantly to hopelessness prediction. Hopelessness assessment could efficiently help health professionals to minimize both inpatient suicide and suicidal acts after discharge.
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Affiliation(s)
- Vasiliki Efstathiou
- a Second Department of Psychiatry , National and Kapodistrian University of Athens, Medical School "Attikon" University General Hospital , Athens , Greece
| | - Athanasia Papadopoulou
- a Second Department of Psychiatry , National and Kapodistrian University of Athens, Medical School "Attikon" University General Hospital , Athens , Greece
| | - Christos Christodoulou
- a Second Department of Psychiatry , National and Kapodistrian University of Athens, Medical School "Attikon" University General Hospital , Athens , Greece
| | - Rossetos Gournellis
- a Second Department of Psychiatry , National and Kapodistrian University of Athens, Medical School "Attikon" University General Hospital , Athens , Greece
| | - Ioannis Michopoulos
- a Second Department of Psychiatry , National and Kapodistrian University of Athens, Medical School "Attikon" University General Hospital , Athens , Greece
| | - Panagiotis Ferentinos
- a Second Department of Psychiatry , National and Kapodistrian University of Athens, Medical School "Attikon" University General Hospital , Athens , Greece
| | - Charalabos Papageorgiou
- b First Department of Psychiatry , National and Kapodistrian University of Athens, Medical School, "Eginition" Hospital , Athens , Greece
| | - Athanassios Douzenis
- a Second Department of Psychiatry , National and Kapodistrian University of Athens, Medical School "Attikon" University General Hospital , Athens , Greece
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Grover S, Mehra A, Dalla E, Chakrabarti S, Avasthi A. A naturalistic 1 year follow-up study of the elderly patients with depression visiting the psychiatric outpatient services for the first time. Psychiatry Res 2018; 267:112-119. [PMID: 29886273 DOI: 10.1016/j.psychres.2018.05.080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 05/04/2018] [Accepted: 05/29/2018] [Indexed: 02/08/2023]
Abstract
This naturalistic study aimed to assess treatment dropout pattern, course of symptoms and outcome of depression among the elderly. This study aimed to assess the course and outcome of depression and treatment dropout pattern of patients with depression in old age. Additionally an attempt was made to study the predictors of outcome and dropout. 140 elderly patients (≥ 60 years) were followed up at 6 months and 1 year to evaluate the status of their depression and treatment pattern. Out of the 140 patients recruited at the baseline, 58 (41.4%) patients did not return to the clinic after the first visit. 65.7%, 75% and 90% patients dropped out from the clinic by 3 months, 6 months and 1 year after registration with the clinic. At 1 year, about two-third (65%) of patients achieved improvement in symptoms to the extent of 81-100% and only 10% did not show any improvement throughout the study period. To conclude present study suggests that large proportion of the elderly patients with depression attending a mental health service dropout of treatment. Despite the high dropouts rate, more than three-fourth of the patients improve to the extent of 81-100% and very few patients have worsening of symptoms or persistent symptoms.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Aseem Mehra
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Eish Dalla
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Subho Chakrabarti
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
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Liu BP, Qin P, Jia CX. Behavior Characteristics and Risk Factors for Suicide Among the Elderly in Rural China. J Nerv Ment Dis 2018; 206:195-201. [PMID: 28825926 DOI: 10.1097/nmd.0000000000000728] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We examine the characteristics of suicide behavior and associated risk factors in the elderly in rural China, compared with the nonelderly. Paired case-control design and psychological autopsy were used for subject recruitment and data collection. The included cases were 104 suicides of the elderly aged 60 years or older, 86 suicides of the nonelderly, and sex- and age-paired controls from the same villages. Although the characteristics of suicide behavior were similar between the two age groups of victims, the elderly who died by suicide had a greater tendency to experience negative life events and not live with a spouse. Suicide of the nonelderly was associated with family history of suicide, poor social support, and impulsivity. The influence of negative life events on the risk of suicide was greater in the elderly. Thus, efforts for suicide prevention must be tailored to the needs of specific age groups.
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26
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Lee H, Seol KH, Kim JW. Age and sex-related differences in risk factors for elderly suicide: Differentiating between suicide ideation and attempts. Int J Geriatr Psychiatry 2018; 33:e300-e306. [PMID: 28967671 DOI: 10.1002/gps.4794] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 08/10/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The purpose of this study was to analyze the age and sex-related differences in socio-demographic factors that influence suicide ideation and attempts in the elderly. METHODS The total number of subjects was 93 151, of whom 8441 belonged to the high suicide-risk group (2064 male; 6377 female). Following this identification, we investigated their socio-demographic information, health status, and depressive symptoms, which might have influenced their suicide ideation and attempts. RESULTS Residence in an urban area was identified as a risk factor for both male and female elderly in their 60s and 70s and female elderly in their 80s. Marital status showed a different influence on suicide ideation depending on age and sex. A negative perception of one's own health status was a significant risk factor that increased the likelihood of suicide ideation in all ages, except the female elderly in their 60s. No factor was identified that significantly influenced suicide attempts in the male elderly. However, in the female elderly, residence in an urban area and a negative perception of one's own health status were identified as significant risk factors. CONCLUSIONS This study revealed that factors known to influence suicide ideation in the elderly from previous studies, such as residence area, separation from a spouse, education level, religion, and drinking, show changed influence as the elderly reach their 70s and 80s. However, a negative perception of one's own health status was a risk factor that encompassed most ages and sexes.
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Affiliation(s)
- Hyuk Lee
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.,Medical Unit of the 7th Division, Korea Army, Hwacheon, Republic of Korea
| | - Ki Ho Seol
- Department of Radiation Oncology, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Jun Won Kim
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
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Karbeyaz K, Çelikel A, Emiral E, Emiral GÖ. Elderly suicide in Eskisehir, Turkey. J Forensic Leg Med 2017; 52:12-15. [PMID: 28772156 DOI: 10.1016/j.jflm.2017.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 06/16/2017] [Accepted: 06/24/2017] [Indexed: 12/20/2022]
Abstract
Old age should be examined separately from other stages of life in terms of ratio, method and motives for suicide. With some variation, epidemiological studies suggest suicides increase with age in virtually every society. This study examines demographic data (age, sex and marital status), and other factors related to 20-years (1997-2016) of completed elder suicides in Eskisehir, Turkey. The 74 cases of those 65 and over were evaluated with regard to method, tool and location of the suicide. Annual distributions illustrate gradual increases in this fatal self-harm over time. The vast majority of cases were male (74.3%), compared to female (25.6%). Elders in the 80-84 age range were most likely to kill themselves. Deaths were frequently caused by hanging, followed by other methods and took place in the home. Reasons associated with suicidal behavior included despair as a result of bereavement, mental illnesses, chronic physical conditions and living alone. The researchers cite potential prevention strategies through the use of early mental health treatment for elders, along with inclusion in social services and activities.
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Affiliation(s)
- Kenan Karbeyaz
- Eskişehir Osmangazi University Faculty of Medicine Department of Forensic Medicine, Eskisehir, Turkey.
| | - Adnan Çelikel
- Mustafa Kemal University Faculty of Medicine Department of Forensic Medicine, Hatay, Turkey.
| | - Emrah Emiral
- Council of Forensic Medicine, Eskisehir, Turkey.
| | - Gülsüm Öztürk Emiral
- Eskişehir Osmangazi University Faculty of Medicine Department of Public Health, Eskisehir, Turkey.
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Shao Y, Zhu C, Zhang Y, Yu H, Peng H, Jin Y, Shi G, Wang N, Chen Z, Chen Y, Jiang Q. Epidemiology and temporal trend of suicide mortality in the elderly in Jiading, Shanghai, 2003-2013: a descriptive, observational study. BMJ Open 2016; 6:e012227. [PMID: 27543591 PMCID: PMC5013362 DOI: 10.1136/bmjopen-2016-012227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To investigate and describe the epidemiological characteristics of suicide in the elderly in Jiading, Shanghai, for the period 2003-2013. DESIGN Retrospective, observational, epidemiological study using routinely collected data. SETTING Jiading District, Shanghai. METHODS Suicide data were retrieved from the Shanghai Vital Registry database for the period 2003-2013. Crude and age-standardised mortality rates were calculated for various groups according to sex and age. Joinpoint regression was performed to estimate the percentage change (PC) and annual percentage change (APC) for suicide mortality. RESULT A total of 956 deaths due to suicide occurred among people aged ≥65 years during the study period, accounting for 76.7% (956/1247) of all suicide decedents. Among the 956 people with suicide deaths, 88.7% (848/956) had a history of a psychiatric condition. The age-standardised mortality rates for suicide without and with a psychotic history in people aged ≥65 years were much higher than those for people aged <65 years in both genders. Suicide mortality in the elderly showed a declining trend, with a PC of -51.5% for men and -47.5% for women. The APC was -29.1 in 2003-2005, 4.6 in 2005-2008 and -9.7 in 2008-2013 for aged men, and -12.2 in 2003-2006 and -5.2 in 2006-2013 for aged women, respectively. Women living in Jiading had a higher risk of suicide death than men, especially among the elderly. The mortality rate for suicide increased with age in the elderly, and was more marked for those with a psychiatric history than for those without. CONCLUSIONS Suicide mortality declined in Jiading during the study period 2003-2013 overall, but remained high in the elderly, especially those with a psychiatric history.
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Affiliation(s)
- Yueqin Shao
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Chenghua Zhu
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Yiying Zhang
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Hongjie Yu
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Hui Peng
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Yaqing Jin
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Guozheng Shi
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Na Wang
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Zheng Chen
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Yue Chen
- Faculty of Medicine, School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Qingwu Jiang
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
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Law CK, Kõlves K, De Leo D. Influences of population-level factors on suicides in older adults: a national ecological study from Australia. Int J Geriatr Psychiatry 2016; 31:384-91. [PMID: 26343391 DOI: 10.1002/gps.4343] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 06/20/2015] [Accepted: 07/17/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The relationship between older adult suicide rates and population-level variables has been examined in a few studies. Therefore, the objective of the present study is to analyse the extent to which population-level factors are associated with suicide by older persons in Australia, from an ecological perspective. METHODS Suicide rates for older adults aged 65 years and over were calculated for 68 observation units at Statistical Areas Level 4 in Australia for 2002-2011. The 2011 Census of Population and Housing was used for population-level variables. Analysis on standardised suicide mortality ratios and Poisson regression were performed to examine geographical and gender differences. RESULTS Between 2002 and 2011, a total of 3133 suicides of persons aged 65 years and above (men: n = 2418, 77.1%) was identified with an average annual rate of 10.1 per 100,000 persons. Suicide rates in older adults vary widely between different geographical regions in Australia. The multivariate estimates of contextual factors showed that the risk of suicide was positively associated with the sex ratio (incidence risk ratio (IRR) = 1.053, 95%CI = 1.016-1.092), the proportion of those in tenant household (IRR = 1.120, 95%CI = 1.081-1.160) and Australian residents born in North-West Europe (IRR = 1.058, 95%CI = 1.022-1.095). Significant gender variations were found. CONCLUSIONS Specific factors increasing risk of suicide for older adults on SA4 level in Australia were living in areas with a higher proportion of male population, a higher proportion of tenant household dwellers and a higher proportion of immigrants from North-West Europe. The different influences of population-level factor on suicide between older men and women indicate the need for targeted suicide prevention activities.
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Affiliation(s)
- Chi-Kin Law
- Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, Griffith University, Brisbane, Queensland, Australia.,The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, Griffith University, Brisbane, Queensland, Australia
| | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, Griffith University, Brisbane, Queensland, Australia
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Fässberg MM, Cheung G, Canetto SS, Erlangsen A, Lapierre S, Lindner R, Draper B, Gallo JJ, Wong C, Wu J, Duberstein P, Wærn M. A systematic review of physical illness, functional disability, and suicidal behaviour among older adults. Aging Ment Health 2016; 20:166-94. [PMID: 26381843 PMCID: PMC4720055 DOI: 10.1080/13607863.2015.1083945] [Citation(s) in RCA: 218] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To conduct a systematic review of studies that examined associations between physical illness/functional disability and suicidal behaviour (including ideation, nonfatal and fatal suicidal behaviour) among individuals aged 65 and older. METHOD Articles published through November 2014 were identified through electronic searches using the ERIC, Google Scholar, PsycINFO, PubMed, and Scopus databases. Search terms used were suicid* or death wishes or deliberate self-harm. Studies about suicidal behaviour in individuals aged 65 and older with physical illness/functional disabilities were included in the review. RESULTS Sixty-five articles (across 61 independent samples) met inclusion criteria. Results from 59 quantitative studies conducted in four continents suggest that suicidal behaviour is associated with functional disability and numerous specific conditions including malignant diseases, neurological disorders, pain, COPD, liver disease, male genital disorders, and arthritis/arthrosis. Six qualitative studies from three continents contextualized these findings, providing insights into the subjective experiences of suicidal individuals. Implications for interventions and future research are discussed. CONCLUSION Functional disability, as well as a number of specific physical illnesses, was shown to be associated with suicidal behaviour in older adults. We need to learn more about what at-risk, physically ill patients want, and need, to inform prevention efforts for older adults.
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Affiliation(s)
| | - Gary Cheung
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | | | - Annette Erlangsen
- Research Unit, Mental Health Centre Copenhagen, Denmark,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Sylvie Lapierre
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Reinhard Lindner
- Geriatric Psychosomatics and Psychotherapy, Medical Geriatric Clinic Albertinen-Haus, University of Hamburg, Hamburg, Germany
| | - Brian Draper
- School of Psychiatry, University of NSW, Sydney, Australia
| | - Joseph J. Gallo
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Jing Wu
- Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden
| | - Paul Duberstein
- Department of Psychiatry and Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Margda Wærn
- Section of Psychiatry and Neurochemistry, University of Gothenburg/Sahlgrenska University Hospital, Gothenburg, Sweden,Corresponding author.
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Cho SE, Na KS, Cho SJ, Im JS, Kang SG. Geographical and temporal variations in the prevalence of mental disorders in suicide: Systematic review and meta-analysis. J Affect Disord 2016; 190:704-713. [PMID: 26600412 DOI: 10.1016/j.jad.2015.11.008] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/01/2015] [Accepted: 11/09/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND In contrast to the previous studies reporting that most suicides occur among people with mental disorders, recent studies have reported various rates of mental disorders in suicide in different geographical regions. We aimed to comprehensively investigate the factors influencing the variation in the prevalence of mental disorders reported among suicide victims. METHOD The authors searched Embase, Medline, Web of Science, and the Cochrane Library to identify psychological autopsy studies reporting the prevalence of any mental disorders among suicide victims. A meta-regression analysis was conducted to identify the potential effects of geographical regions, the year of publication, measurements of personality disorder, measurements of comorbidity, and the ratio of females on the prevalence of mental disorders in addition to examining the heterogeneity across studies. RESULTS From 4475 potentially relevant studies, 48 studies met eligibility criteria, with 6626 suicide victims. The studies from East Asia had a significantly lower mean prevalence (69.6% [95% CI=56.8 to 80.0]) than those in North America (88.2% [95% CI=79.7-93.5]) and South Asia (90.4% [95% CI=71.8-97.2]). The prevalence of any mental disorder decreased according to the year of publication (coefficients=-0.0715, p<0.001). LIMITATIONS Substantial heterogeneities were identified within all subgroup analyses. CONCLUSIONS The prevalence of mental disorders among suicide cases seemed relatively low in the East Asia region, and recently published studies tended to report a lower prevalence of mental disorders. The link between the risk factors and suicide in the absence of a mental disorder should be examined in different geographical and sociocultural contexts.
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Affiliation(s)
- Seo-Eun Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Kyoung-Sae Na
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea.
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jeong-Soo Im
- Department of Preventive Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Seung-Gul Kang
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea
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33
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Sutin AR, Stephan Y, Carretta H, Terracciano A. Perceived discrimination and physical, cognitive, and emotional health in older adulthood. Am J Geriatr Psychiatry 2015; 23:171-9. [PMID: 24745563 PMCID: PMC4170050 DOI: 10.1016/j.jagp.2014.03.007] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 03/05/2014] [Accepted: 03/16/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine whether perceived discrimination based on multiple personal characteristics is associated with physical, emotional, and cognitive health concurrently, prospectively, and with change in health over time among older adults. DESIGN Longitudinal. SETTING Health and Retirement Study (HRS). PARTICIPANTS Participants (N = 7,622) who completed the Leave-Behind Questionnaire as part of the 2006 HRS assessment (mean age 67 years); participants (N = 6,450) completed the same health measures again in 2010. MEASUREMENTS Participants rated their everyday experience with discrimination and attributed those experiences to eight personal characteristics: race, ancestry, sex, age, weight, physical disability, appearance, and sexual orientation. At both the 2006 and 2010 assessments, participants completed measures of physical health (subjective health, disease burden), emotional health (life satisfaction, loneliness), and cognitive health (memory, mental status). RESULTS Discrimination based on age, weight, physical disability, and appearance was associated with poor subjective health, greater disease burden, lower life satisfaction, and greater loneliness at both assessments and with declines in health across the four years. Discrimination based on race, ancestry, sex, and sexual orientation was associated with greater loneliness at both time points, but not with change over time. Discrimination was mostly unrelated to cognitive health. CONCLUSIONS The detrimental effect of discrimination on physical and emotional health is not limited to young adulthood but continues to contribute to health and well-being in old age. These effects were driven primarily by discrimination based on personal characteristics that change over time (e.g., age, weight) rather than discrimination based on more stable characteristics (e.g., race, sex).
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Akar T, Karapirli M, Akcan R, Demirel B, Akduman B, Dursun AZ, Sari S, Özkök A. Elderly deaths in Ankara, Turkey. Arch Gerontol Geriatr 2014; 59:398-402. [PMID: 24962235 DOI: 10.1016/j.archger.2014.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 05/20/2014] [Accepted: 05/21/2014] [Indexed: 10/25/2022]
Abstract
According to World Health Organization, the life expectancy at birth is increasing. An increase in life expectancy might result in increased morbidity and mortality in elderly. The increase in the elderly population also leads to an increase in medico-legal problems, as well. Autopsy is of high importance for determination of cause of death in clinical and forensic cases. The purpose of this study was to find out general characteristics elderly deaths by examining forensic autopsy records. Out of 7033 forensic autopsies performed between years of 2007 and 2011, 1324 were elderly deaths and were included in the scope of the study. The records of public prosecutor office, crime scene investigation and autopsy findings were examined. The majority of victims (70.6%) were male, while 29.4% were female, with a male to female ratio of 2.4/1. Victims' ages ranged between 65 and 96 years, and the mean age was 74.8 years. A great number of presented elderly deaths were due to unnatural causes, followed by natural deaths cases. Out of unnatural deaths, 63.2% were related to accidents, 23.7% were suicides, and remaining 13.1% were homicides. More than half (56.6%) of all suicidal deaths were due to hanging. Of natural deaths, the majority (82.7%) were due to cardiovascular system disease. In the presented series the cause of death was determined in 90.9% of all elderly deaths, which validates the need for a forensic autopsy. Data obtained through autopsy procedures is of high importance for death statistics.
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Affiliation(s)
- Taner Akar
- Gazi University School of Medicine, Department of Forensic Medicine, Besevler, Ankara, Turkey.
| | - Mustafa Karapirli
- Council of Forensic Medicine Ankara Group Administration, Kecioren, Ankara, Turkey
| | - Ramazan Akcan
- Hacettepe University School of Medicine, Department of Forensic Medicine, Sıhhiye, Ankara, Turkey
| | - Birol Demirel
- Gazi University School of Medicine, Department of Forensic Medicine, Besevler, Ankara, Turkey
| | - Barış Akduman
- Council of Forensic Medicine Ankara Group Administration, Kecioren, Ankara, Turkey
| | - Ahmet Zahit Dursun
- Gazi University School of Medicine, Department of Forensic Medicine, Besevler, Ankara, Turkey
| | - Serhat Sari
- Gazi University School of Medicine, Department of Forensic Medicine, Besevler, Ankara, Turkey
| | - Alper Özkök
- Gazi University School of Medicine, Department of Forensic Medicine, Besevler, Ankara, Turkey
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